Pogo had it right
'World class" is a phrase thrown around all too casually, but here in Massachusetts we are justifiably proud of our world-class healthcare institutions. We have some of the best hospitals in the world. Our health insurers are consistently rated as among the most consumer-friendly in the nation. We are home to Harvard Medical School and the New England Journal of Medicine, two of the best brands in their fields. We are the center of the burgeoning life sciences industry.
And so, by extension, are we among the healthiest people in the land? Hardly, says a surprising new national study, which ranks Massachusetts in the bottom quartile of states when it comes to the most common chronic diseases such as cancers, stroke, and pulmonary conditions. And the threat not only to our health but our economic well-being is likely to get worse if we continue on our present course.
The study by the Milken Institute ranks Massachusetts 40th in the country when it comes to an index of seven chronic diseases. The Commonwealth finished just ahead of Alabama and just behind South Carolina in the Milken rankings. Two other New England states, Maine and Rhode Island, were in the bottom 10.
The Milken Institute, a well-regarded California economic think tank, attributes Massachusetts' low ranking to our high incidence of cancers and "perhaps better reporting rates." The report shows Massachusetts in the five states with the highest rates of breast cancer, pulmonary conditions, and mental disorders.
The findings, to be discussed this morning at a conference of the New England Healthcare Institute at the Colonnade Hotel, are in contrast to a report this year by the institute and the Boston Foundation that found the health of Greater Boston residents to be good and our life expectancy longer compared to the rest of the country. But that report, like the Milken report, cited the state's high prevalence of cancers and other chronic diseases. And most importantly both studies came to the same central conclusion: Massachusetts, like the country at large, faces a huge and rising bill from chronic diseases that are largely preventable.
Whether Massachusetts ranks fourth or 40th, the economic cost is staggering. The seven diseases Milken focused on were: cancers, diabetes, heart disease, hypertension, stroke, mental disorders, and pulmonary conditions. In Massachusetts alone the cost of treatment was $8.1 billion in 2003, the report said, with another $25.9 billion lost in missed workdays and lower employee productivity. Total annual cost: $34 billion.
That number is only likely to go up, considering the nature of healthcare costs and our aging population. But it doesn't mean we are helpless. By instituting what it calls "reasonable improvements in preventing and managing chronic disease," the Milken report estimates Massachusetts could cut its future economic costs by 26 percent, or nearly $25 billion, by 2023. Nationally, Milken says the annual economic impact of chronic disease is $1.3 trillion a year, a number that could balloon to nearly $6 trillion by the middle of the century.
The rising cost of healthcare is the story that won't go away. It is a significant piece of every car we buy, every subway ride we take, every property tax bill we curse. While the numbers are daunting and the issues seem intractable, the solutions are, in large measure, as controllable as what we eat, if we smoke, and what we do or don't do. To make a difference we need policies that create more incentives to promote prevention and early intervention. And a renewed commitment to making obesity public enemy number one.
Pogo had it right: "We have met the enemy and he is us." You'll find me in the gym this morning trying to work off some of this fat. And you, my friends?
Steve Bailey is a Globe columnist. He can be reached at bailey@globe.com or at 617-929-2902. 